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Case Reports
. 2021 Sep 22;14(9):e244284.
doi: 10.1136/bcr-2021-244284.

Stroke and refractory hypoxaemia: complications of pulmonary embolism

Mafalda Sá Pereira  1 , Rita Homem  1 , Tiago Judas  1 , Francisca Delerue  2
Affiliations
Case Reports

Stroke and refractory hypoxaemia: complications of pulmonary embolism

Mafalda Sá Pereira et al. BMJ Case Rep. .

Abstract

Acute pulmonary embolism is one of the main causes of cardiovascular mortality. Treatment should be guided according to mortality risk stratification, but an individualised and multidisciplinary approach is often required. Concomitant persistent hypoxaemia can be present in cases of intracardiac shunt. In this report, we describe a 46-year-old woman with a history of surgery, presenting with pulmonary embolism with refractory hypoxaemia and simultaneous ischaemic stroke. Fibrinolysis was successfully performed, and the patient made a full recovery. Additional investigations identified a patent foramen ovale, which was later closed. She had no recurrent thrombotic events.

Keywords: cardiovascular medicine; stroke; venous thromboembolism.

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Conflict of interest statement

Competing interests: None declared.

Figures

Figure 1
Figure 1
CT pulmonary angiography: (A) bilateral pulmonary thromboembolism (yellow arrows), (B) signs of right ventricular dysfunction (orange arrow).
Figure 2
Figure 2
CT of the head showed no signs of ischaemia or haemorrhage.
Figure 3
Figure 3
MRI of the head showing high density signal at left cortico-temporal topography (arrow) representing infarct area, in diffusion-weighted imaging.
See this image and copyright information in PMC

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